Amin Madani1, Yusuke Watanabe2, Melina Vassiliou1, Liane S Feldman1, Quan-Yang Duh3, Michael C Singer4, Daniel T Ruan5, Roger Tabah6, Elliot Mitmaker7. 1. Department of Surgery, McGill University, Montreal, Quebec, Canada; Centre for Minimally Invasive Surgery and Innovation, McGill University, Montreal, Quebec, Canada. 2. Centre for Minimally Invasive Surgery and Innovation, McGill University, Montreal, Quebec, Canada. 3. Department of Surgery, University of California, San Francisco, San Francisco, CA. 4. Department of Otolaryngology, Henry Ford Hospital, Detroit, MI. 5. Department of Surgery, Brigham and Women's Hospital, Boston, MA. 6. Department of Surgery, McGill University, Montreal, Quebec, Canada. 7. Department of Surgery, McGill University, Montreal, Quebec, Canada. Electronic address: elliot.mitmaker@mcgill.ca.
Abstract
BACKGROUND: Current methods for teaching and assessing competencies that characterize expert intraoperative performance are inconsistent, subjective, and lack standardization. This mixed-methods study was designed to define and establish expert consensus on the most important competencies required to perform a thyroidectomy safely. METHODS: Cognitive task analyses for thyroidectomy were performed with semistructured interviews of experts in thyroid surgery. Verbal data were transcribed verbatim, coded, and categorized according to themes that were synthesized into a list of items. Once qualitative data reached saturation, 26 experts were invited to complete 2-round online Delphi surveys to rank each item on a Likert scale of importance (1-7). Consensus was predefined as a Cronbach's α ≥ 0.80. RESULTS: Sixty items were synthesized from 5 interviews and categorized into 8 sections: preparation (n = 8), incision/exposure (n = 11), general considerations (n = 4), middle thyroid vein (n = 1), superior pole (n = 5), inferior pole (n = 5), posterolateral dissection (n = 19), and closure (n = 7). Eighteen (69%) experts from 3 countries participated in the Delphi survey. Consensus was achieved after 2 voting rounds (Cronbach's α = 0.95). Greatest weighted sections included "Superior Pole Dissection" and "Posterolateral Dissection." CONCLUSION: Consensus was achieved on defining the most important competencies for safe thyroidectomy. This blueprint serves as the basis for instructional design and objective assessment tools to evaluate performance.
BACKGROUND: Current methods for teaching and assessing competencies that characterize expert intraoperative performance are inconsistent, subjective, and lack standardization. This mixed-methods study was designed to define and establish expert consensus on the most important competencies required to perform a thyroidectomy safely. METHODS: Cognitive task analyses for thyroidectomy were performed with semistructured interviews of experts in thyroid surgery. Verbal data were transcribed verbatim, coded, and categorized according to themes that were synthesized into a list of items. Once qualitative data reached saturation, 26 experts were invited to complete 2-round online Delphi surveys to rank each item on a Likert scale of importance (1-7). Consensus was predefined as a Cronbach's α ≥ 0.80. RESULTS: Sixty items were synthesized from 5 interviews and categorized into 8 sections: preparation (n = 8), incision/exposure (n = 11), general considerations (n = 4), middle thyroid vein (n = 1), superior pole (n = 5), inferior pole (n = 5), posterolateral dissection (n = 19), and closure (n = 7). Eighteen (69%) experts from 3 countries participated in the Delphi survey. Consensus was achieved after 2 voting rounds (Cronbach's α = 0.95). Greatest weighted sections included "Superior Pole Dissection" and "Posterolateral Dissection." CONCLUSION: Consensus was achieved on defining the most important competencies for safe thyroidectomy. This blueprint serves as the basis for instructional design and objective assessment tools to evaluate performance.
Authors: Amin Madani; Jordan Gornitsky; Yusuke Watanabe; Cassandre Benay; Maria S Altieri; Philip H Pucher; Roger Tabah; Elliot J Mitmaker Journal: World J Surg Date: 2018-02 Impact factor: 3.352
Authors: Jacob Melchiors; Mikael Johannes Vuokko Henriksen; Frederik G Dikkers; Javier Gavilán; J Pieter Noordzij; Marvin P Fried; Daniel Novakovic; Johannes Fagan; Birgitte W Charabi; Lars Konge; Christian von Buchwald Journal: Eur Arch Otorhinolaryngol Date: 2018-02-13 Impact factor: 2.503
Authors: Rebecca L Sudore; Daren K Heyland; Hillary D Lum; Judith A C Rietjens; Ida J Korfage; Christine S Ritchie; Laura C Hanson; Diane E Meier; Steven Z Pantilat; Karl Lorenz; Michelle Howard; Michael J Green; Jessica E Simon; Mariko A Feuz; John J You Journal: J Pain Symptom Manage Date: 2017-09-01 Impact factor: 3.612